Thoracic epidural catheter for postoperative pain control following an ineffective transversus abdominis plane block using liposome bupivacaine
| Autor: | Nicholas C Connolly, Charles C Stehman, Gabriel A Rodriguez, Brian D Terrien, David Espinoza |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
plasma bupi-vacaine levels
medicine.medical_specialty medicine.medical_treatment Case Report 01 natural sciences 03 medical and health sciences 0302 clinical medicine Thoracic epidural Transversus Abdominis Plane Block medicine Colectomy Bupivacaine Liposome liposome bupivacaine (bupivacaine liposome injectable suspension) 010405 organic chemistry business.industry Hydromorphone medicine.disease Ulcerative colitis transversus abdominis plane (TAP) nerve block 0104 chemical sciences Surgery Catheter thoracic epidural Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Anesthesia business medicine.drug |
| Zdroj: | Journal of Pain Research |
| ISSN: | 1178-7090 |
| DOI: | 10.2147/jpr.s111589 |
| Popis: | A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels. |
| Databáze: | OpenAIRE |
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